Setting Your New Year’s Intentions


The start of a new year is a perfect time to think about the person you want to be and the life you want to live. Whether 2013 was filled with joy, beauty, and fulfillment of your goals or, alternatively, pain, loss and resolutions left unkept, now is the time to reflect and set intentions.

I have written resolutions – and, more recently, new year’s intentions, for as long as I can remember.  People so often make light of resolution’s ephemeral nature or, worse, harbor feelings of failure tied to abandoned resolutions.  Resolutions are about fixing a personal flaw- and we don’t need to be fixed.  Listing a set of quantitative resolutions does not set most people up for success.  Intentions, on the other hand, invoke a process and an ongoing effort to live a life on path with your authentic desires.

Here are a few tips I’ve learned over the years.

1.    Give yourself time to think about your intentions for 2014

You do not need to wait until you have had your first glass of champagne on the eve of 2014 to think about next year’s intentions.  Start now by reflecting and honoring 2013 – whether for the joys it brought or the hardships endured (and the wisdom that come from each) and set the stage to welcome 2014.

2.    Think about the person you want to be and the life you want to lead

Try to move away from what you think you should accomplish this year, such as losing 5 pounds, stopping smoking, or exercising 5 days/week.  These tend to be on the failed resolution list.  And, while these are all excellent goals, the purpose of making intentions is to help you lead a life in line with your core beliefs and passions.  Generally, we do want just these goals – we want them because of what we believe we will experience by having them in our life.  Craft resolutions that will help you stay on this path.

3.    Be playful and appreciate the simple pleasures of life

Think about things that sound fun.  One of my patients’ intention for 2014 is to “be more silly”.  Her specific desire for “being silly” is to  “wear a wig for a day”.  A close friend of mine confessed that she is struggling with all of her kids’ structured activities (e.g. ballet, soccer, piano, gymnastics) – her intention is to have more fun and, more specifically, “bring a thermos of hot chocolate, lots of blankets and take the kids to beach this winter.”  These are often easily attainable activities that support your intentions.

4.    Come up with a list of areas in your life that are important to you

Think about what is important to you. Consider new skills you want to learn, qualities you want to cultivate, and experiences you want to have.

For example:

  • Health
  • Family
  • Relationships
  • Work
  • Social
  • Financial
  • Personal Growth
  • Joy

With all of this in mind, write your intentions within the categories that resonate with you. This is enough. However, to help with manifesting your stated intentions, write an action step for each intention.

Here are a few new year intentions and action steps I have collected from friends and patients over the years.


  •  “Be peaceful”.  Action step: “practice yoga consistently, get stronger at navasana (boat pose) and create a space to practice at home.”
  • “Loving”. Action step, “date night 1x/month with husband”.
  •  “Experience abundance with money”. Action step: “read a book on investing and make a plan each month on specific ways to increase income”.
  • “Continued personal growth”. Action step:  learn to spell “restaurant” (this one is mine—it just that word that spell check always gets me on – I put the “u” in front of the “a” every time until I sat down for 5-mintues and really learned how to spell it).  Action step: “read a new biography every month”. Action step: “learn to put on false eye lashes”.  This was something a friend of mine always wanted to learn – and now she can apply those long lashes whenever she wants.
  • “Mindfulness”.  Action step: “allow 15-minutes 2x/day with complete uninterrupted time with family. Phones and computers off.”  Another action step: “Take 3 breaths before eating to set an intention for the meal- such as eating slowly and mindfully, chewing the food thoroughly or placing the fork down between bites”.

Write down what you truly want, treat the new year as a gift, and have fun.









What Every Woman Needs to Know About Anal Cancer

images-2It’s women’s health week and a wonderful opportunity for women to make their health a priority and be proactive in the healthcare they receive from their doctors. I want to bring  our attention to the health of our buttocks and, more specifically, to HPV and its role in anal cancer.

Farrah Fawcett’s battle with anal cancer brought this illness to the minds of women everywhere. Women (and so many of my own patients) who make healthy decisions every day to eat organic, dark leafy greens, practice yoga, meditate and see their doctors yearly for preventative wellness exams were never concerned with anal HPV and cancer. I was rarely asked about anal cancer prior to Farrah’s public acknowledgment. After Farrah’s death, questions about anal cancer and how best to screen for anal cancer became common.

Human papilloma virus (HPV) is well known. HPV is a common sexually transmitted virus which can cause the cells of the cervix to change and, if left unmonitored and untreated, turn into cervical cancer. HPV is also associated with other cancers, including, cancer of the penis, vulva, vagina, throat, and anus.  There was a 3-fold increase in the incidence of anal cancer between 1973 and 1998.   In 2012, there were 6,230 new cases and 780 deaths from, anal cancer.

Major risk factors identified for anal cancer include:

  • Anal intercourse
  • IV drug use
  • Abnormal pap smears
  • HIV infection
  • Anal HPV

Women must raise their concerns about screening for anal cancer with their doctors.  Unfortunately, at this time, there are no established guidelines for routine screening for anal HPV and anal cancer.  As a result, these screenings are often omitted from annual exams. Many doctors are unsure of how to screen for anal cancer. Anal pap smears do exist, but they are not FDA approved.  There is also a lack of accuracy in anal pap testing – with sensitivity and specificity fluctuating from 40% to 95% with repeated specimen collection.

So what should women and their doctors do to screen properly and prevent anal cancer?  Know your risk factors and discuss them with your doctor.  In addition, I recommend digital rectal exams and anal pap smears in the following women:

  • Any woman who has HPV and engages in anal sex. Most likely, her male partner has the HPV virus which increases the chance of the HPV virus transferring to anal cells.
  • Any woman with a history of HPV or cervical dysplasia who is immunosuppressed due to HIV or having had an organ transplant.

We are at a time where anal HPV screenings are not standard of care.  Pap smears, mammograms, colonoscopies and checking for anemia, for example, are other screening tests that most doctors know when to start testing and how often. This is not the case with anal pap smears. Screening is left up to a doctor’s clinical judgment. If your doctor does not bring the subject up with you, I encourage you to approach your doctor and ask whether anal HPV screening is appropriate for you.  Although anal pap smears are not, at this time, absolutely accurate, their success at detecting cancer far exceeds doing nothing.



“Optimal Parenting 101″

I am excited to be part of  a carefully selected panel of experts for “Optimal Parenting 101″ an online course offered April 8-12, 2013.  I will be discussing the importance of preconception healthcare in having a healthy and joyful pregnancy, birth and baby.

This course is free and offered through En*theous University – an online academy devoted to optimal living.

Sign up for your free ticket:

DHA supplementation in pregnancy

A new study in The American Journal of Clinical Nutrition lends support to the claim that supplementing with DHA in pregnancy helps with optimal pregnancy outcomes. Earlier research on the benefits of DHA supplementation in pregnancy has shown that it plays a substantial role in fetal and infant brain development, increasing IQ scores, lengthening attention spans, and enhancing fetal and infant eye development. I wrote about the many benefits of DHA supplementation during pregnancy, and what DHA is, in a past blog post.

The new study concluded that supplementing with 600mg/day in the last half pregnancy resulted in:

- longer gestations

- bigger babies

- fewer preterm births

Not only does DHA prevent preterm and low-birth weight babies (which addresses an important public healthcare concern) it also helps make smart babies and prevents against postpartum depression.

Healthy Gut Flora in Babies

Here’s an interesting article I found yesterday in the NY Times which reports on a recent study published in the CMAJ about healthy gut flora in babies. This report suggests that babies born vaginally and babies who are breast feed may have healthier gut flora than babies born via C-section and fed only formula. Healthy gut flora – which consists of many different types of probiotics and prebiotics- are essential for a strong immune and healthy digestive system. Several previous studies have linked healthy gut flora to regular bowel movements, healthy digestion, strong immune system and better mood. An imbalance in gut microbes – or, “Dysbiosis” – can contribute to inflammatory bowel disease, asthma, childhood obesity, eczema and allergies.

Babies are inoculated with healthy bacteria when they pass through the vaginal canal during labor. The vagina is a prime location for probiotics like Lactobacillus acidophilus. Probiotics are also passed through the mother’s breast milk. In order to optimize baby exposure to these healthy bugs, mothers should supplement with probiotics during pregnancy and breast feeding. For babies that need to be born via C-section – or when mothers have difficulty with breastfeeding or baby does not have access to breastmilk – babies can  supplement with probiotics. There are several infant probiotic formulas that can be given to support healthy gut development in the newborn.

FDA is lowering recommended dose for insomnia drug Ambien

FDA approved the use of Ambien in 1992. Now, with over 20-years of use, the FDA is changing its recommended dosage guidelines for safety reasons.  New research is showing that taking the medication zolpidem (i.e. Ambien) at night can impair morning alertness in women. The data implies that Ambien’s sedative and hypnotic effects linger longer in the body then previously thought. These effects can be subtle. Someone can feel totally awake, but their response time may be impaired in activities that require alertness, like driving. The lingering next morning impairment is greater in women since women process the medication at a slower rate then men.

The FDA is recommending that the starting dose of Ambien be lowered from 10mg to 5mg for the immediate release products and from 12.5mg to 6.25mg for the extended-release products.

The FDA is not infallible. Even though it has endorsed a drug at a given dosage, we still have to be wary when selecting FDA-approved medications. The long-term side effects of many drugs are often unknown until the drug has been in use for several years. I am not saying don’t trust the FDA, but we cannot blindly accept its recommendations without being aware that this may not be the last word on safety.

Peak Fertility Days

Women are fertile about 4-5 days a month- assuming ovulation occurs every month. Women are only fertile if they ovulate (this may seem obvious but I have been asked this question many, many times over the years).   During the time of ovulation, an egg is released from the ovaries and is available for fertilization for about 12-24 hours.  Sperm, however, can live in our bodies for roughly 72-hours. So, women can  get pregnant 2-3-days before, or after, ovulation. Understanding our body’s unique rhythm and cycle can help increase our chances of conception.

There is a myth that ovulation occurs on the 14th day of a menstrual cycle (day 1 is considered the first day of your period).  I have seen this myth prevent many couples who have desired pregnancies from attaining one.  Ovulation can differ from woman to woman and can even be different from month to month.

Our peak fertility day is generally a day before ovulation or on the day of ovulation itself.   Our peak day is considered the last day of either:

1.  Cervical fluid that resembles eggwhites (slippery, clear and stretchy).

2. Lubricative vaginal sensation – generally wet and slippery

3. midcycle spotting

Generally, basal body temperature (a women’s temperature first thing in the morning, before getting out of bed) will elevate 0.5-1 degree 24-48 hours after the peak day.  It is still possible to conceive during the first 2-3-days of temperature elevation but these are not your most fertile days. And, you can feel fairly confident that conception will not occur after the 3rd day of temperature elevation.

Also, a woman’s cervix changes during her fertile time. As a woman approaches ovulation, her cervix tends to rise, soften and open. Women may feel a slight twinge around the ovaries, experience bloating, and have an increase in sex drive. Nature really does work for us to get pregnant- enhanced sex drive to increase chance of receiving sperm, cervical fluid that helps draw sperm through the more open cervix to finally meet egg and fertilize.

Knowing our body’s natural rhythm and cycle is empowering. By charting these fertility signs, women can tell if they are ovulating and if getting pregnant is a possibility at different times of the months.


Carbs can Increase the Risk of Early Alzheimer’s

I just came across this article reporting that carbohydrates can increase risk of Alzheimer’s disease while protein and fat  actually decrease the risk of developing Alzheimer’s. This article was published in the “Star Tribune” and discusses the study that was  recently published in the Journal of Alzheimer’s Disease (I’m working on tracking down the study). According to this article, people who fill their plate with bread and pasta had up to a 4x increase risk of developing Alzheimer’s. In contrast, those who ate mostly protein (beans, fish, and lean meats) and fat (olive oil, avocado) decreased their risk by 42%.

Why do carbs contribute to cognitive decline? Carbohydrates, especially processed carbs like pasta, breads and crackers, are easily converted into sugar in our body.  It is believed that sugar affects blood vessels in the brain and contribute to the formation of amyloid plaques. Amyloid plaques are protein fragments that clog the spaces between nerve cells in the brain and are a defining feature Alzheimer’s disease.

In addition to eating a diet rich in vegetables and protein, we also know that having balanced hormones during the aging process is another significant step in the prevention of Alzheimer’s.  It is exciting how much we are learning about the many preventative measures to ensure cognitive strength during the aging process.

Treating Childhood Ear Infections with Antibiotics Increases risk for Inflammatory Bowel Disease

A recent article in Pediatrics reports that exposure to antibiotics during childhood is associated with the development of inflammatory bowel disease (IBD).

IBD is a group of inflammatory conditions that affect the digestive tract. The major forms are Cohn’s disease and ulcerative colitis. They are very different diseases but may both present with abdominal pain, bloody diarrhea, vomiting, intense abdominal cramping, weight loss, joint pain, and visually changes.

IBD is different then IBS (Irritable bowel syndrome) which tends to be associated with milder forms of bloating, abdominal pain, constipation and diarrhea. Both IBS and IBD are generally associated with disruption of our intestinal flora –and a major cause of this flora disruption is exposure to antibiotics. The most common cause of childhood exposure to antibiotics is during treatment of ear infections. Childhood ear infections, however, can often heal on their own without antibiotics and can be treated with some very effective natural therapies.

I believe that a well functioning digestive tract is at the core of our health and wellbeing. Our entire digestive tract is coated with bacteria – good bacteria –that provide a natural barrier against undigested food, parasites, harmful bacteria, viruses, and toxins. Our good bacteria are essential for healthy digestion, strong immune system and the production of serotonin – our happy hormone. When the good bacteria of our digestive tract is disrupted we are susceptible to digestive distress, a weaker immune system, and even mood changes. Probiotics are “good bacteria” that help to replace the beneficial bacteria that are killed while taking an antibiotic. This article provides a strong reminder of the potentially deleterious consequences of indiscriminate antibiotic use in young children. When it is necessary to be treated with antibiotics, it is essential to supplement with a high quality probiotic.


A link to our segment on the The Doctors

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Thank you!